Biomedical subjects
Publications and source records attributed to C Lusink.
A case of intrahepatic gallbladder--a rare anomaly of the biliary tree which predisposes towards the formation of calculi--is reported. The special difficulties which may be encountered in the management of the complications of cholelithiasis in these circumstances are described.
In a prospective randomized double-blind trial using a 1 g single dose of cephamandole versus placebo, given 1 h before surgery, the wound infection rate after elective surgery for gallbladder stones in 200 consecutive cases was 11%, being 15% in the placebo group and 7% in the cephamandole group (chi 2 = 4.03; P less than 0.05). The average hospital stay was 7.7 days in the absence of wound infection and 13.6 days in the presence of wound infection. Contaminated bile was significantly positively related to wound infection, and cephamandole significantly protected the culture-positive group from wound infection.
A simple, safe, rapid and accurate technique is described for cytological diagnosis of ulcerated or nodular rectal cancer done while performing digital rectal examination or sigmoidoscopy. In 21 cases, there were 17 true positives and no false positives for cancer. There were two true negatives and one false negative for rectal cancer. It is important to exclude prostatic cancer if, in the male, the lesion is anterior and situated at or near the level of the prostate gland, and this can be done using an immunoperoxidase technique which will identify cancer cells of prostatic origin.
The endoscopic diagnoses of 51 patients with carcinoma of the oesophagus and cardia were studied. Tissue for histology and cytology was obtained through either the flexible (28) or rigid (23) endoscope and the results compared. Squamous cell carcinoma was diagnosed accurately (100%) by either method. Adenocarcinoma was poorly diagnosed by flexible endoscopy (five out of 13 with one false positive) while rigid endoscopy remained accurate (six out of six). Misdiagnosis with the flexible endoscope has been shown to occur in the presence of inflammation of the mucosa or tumour infiltration of the submucosa of the lower oesophagus. This has been attributed to the inadequacy of the specimen size for accurate diagnosis in these circumstances.